Individual
KATRINA J. DESHANEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 MEDICAL CENTER DR # 1000, LEBANON, NH 03756-0001
(603) 650-5000
(603) 640-1228
Mailing address
18 ROBERTS RD, CANAAN, NH 03741
(603) 523-4343
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
085004361
IL
363A00000X
Physician Assistant
Primary
1489
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433129199
—
ME
01
—
MM9086
MEDICARE GROUP NUMBER
ME
Enumeration date
10/14/2008
Last updated
12/10/2025
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